Doctors group calls on Ottawa to rethink cuts to refugee health program

Philip Berger

VINCE TALOTTA/TORONTO STAR

Dr Philip Berger of St Michaels Hospital talks to protesters in front of Citizenship and Immigration's Toronto headquarters on St. Clair street to protest against Ottawa's planned health care cuts to refugees on June 18, 2012.

TORONTO Pregnant women and their babies are among those experiencing the worst fallout from Ottawa’s decision to scale back funding for refugee health care, says a group of doctors protesting changes to the program.

Canadian Doctors for Refugee Care said Thursday that three months after cuts to the Interim Federal Health Program took effect, it is marred by confusion, unnecessary costs and compromised care.

The physicians group has been documenting dozens of patient cases since the changes to the program were announced June 30, including that of a young female refugee claimant left pregnant after being used as a sex slave. The woman, 18 weeks pregnant, has no IFH coverage for obstetrical care.

“The IFH Program is in disarray and being mismanaged and the health of all refugees is being placed at risk,” said Dr. Philip Berger, chief of family and community medicine at St. Michael’s Hospital in Toronto.

“It appears to be disproportionately affecting pregnant women and their babies, because there’s a time limit by which they need medical care, obviously,” Berger said in an interview, explaining that claimants must wait up to six weeks for health coverage after seeking refugee status.

“So we know of independently confirmed cases — we’ve spoken to health-care providers directly — where women are in their very last four weeks of pregnancy and cannot get any care and are advised to just show up at an emergency department when they go into labour.”

Six such cases have been seen at one small clinic alone in the last three months, the group said.

“The government is telling some of the most vulnerable members of society they are not eligible for important, possibly life-saving health coverage,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women’s College Hospital in Toronto.

Other cases documented by Canadian Doctors for Refugee Care include:

• A man requiring urgent eye surgery to prevent blindness is refused IFH coverage because he is said to be an “illegal migrant expected to leave the country.” His doctor performs the surgery anyway. Ten days later, he receives notification from Citizen and Immigration Canada that he is eligible to apply for permanent residency status.

• A refugee claimant, 36 weeks’ pregnant, is told by her obstetrician to bring in $3,000 for her next appointment because the IFH will no longer provide insurance for her pregnancy and delivery. Weeks later, following an investigation, the program admits a mistake was made and the woman will be covered.

A spokeswoman for Citizenship and Immigration Minister Jason Kenney responded to the criticisms by saying: “Unfortunately, a small number of activist physicians continue to make unsubstantiated claims and use examples of individuals without disclosing their names so that the facts of these cases cannot be verified or disproved.”

“The majority of the alleged cases … are either factually incorrect or the real status of these individuals has been purposely altered,” Kenney’s press secretary, Alexis Pavlish, said by email.

Pavlish said any “refugee claimant” in Canada has the same access to health care as any Canadian taxpayer, including doctors visits and pregnancy care.

“The changes ensure that bona fide refugees continue to receive comprehensive health coverage, while illegal immigrants and failed asylum seekers from safe, democratic countries no longer receive health insurance that is superior to that which is generally available to taxpaying Canadians, including Canadian seniors.”

Even though Ottawa’s reversal of some planned cuts lessened their overall severity, the doctors group said uncertainty and anxiety about changes to the program persist. That’s because a list of Designated Countries of Origin — which will determine further reductions in coverage for some refugees — has yet to be released.